Regular Physical Activity Improves Neurological Outcomes in New-onset type 2 Diabetic Patients

Studies have shown that physical activity is also associated with a reduced risk of dementia, and the current World Health Organization guidelines on dementia recommend that adults with normal cognition should perform physical activities to reduce the risk of cognitive decline. However, the effect of PA in dementia on patients with new-onset type 2 diabetes remains understudied. Therefore, Dr Jung Eun Yoo and her team conducted a study to investigate the association between interval changes in physical activity (PA) and dementia risk among patients with new-onset type 2 diabetes.

In this study, the researchers used data from the Korean National Health Insurance Service database and identified 133,751 participants newly diagnosed with type 2 diabetes in a health screening (2009–2012), with a follow-up health screening within 2 years (2010–2015). They categorized PA level changes into continuous lack of PA, decreaser, increaser, and continuous PA groups. They determined using dementia diagnosis codes and anti-dementia drug prescriptions. They also determined regular physical activity as at least 30 minutes of moderate physical activity occurring at least 5 times per week or at least 20 minutes of vigorous physical activity occurring at least 3 times per week. The major outcome assessed was newly diagnosed dementia categorized as Alzheimer's disease (AD) and vascular dementia.

Key findings of the study:

• Upon median follow-up of 4.8 years, the researchers observed 3,240 new cases of all-cause dementia.
• They found that regular PA was associated with lower risks of all-cause dementia (adjusted hazard ratio [aHR] 0.82), Alzheimer's disease (AD) (aHR 0.85), and vascular dementia (VaD) (aHR 0.78).
• They noted, increasers who started to engage in regular PA had a lower risk of all-cause dementia (aHR 0.86).
• They observed that the risk was further reduced among those with continuous regular PA: all-cause dementia (aHR 0.73), AD (aHR 0.74), and VaD (aHR 0.62).
• They further noted that the results were consistent in various subgroup analyses.

The authors concluded, "Regular PA was independently associated with lower risks of all-cause dementia, AD, and VaD among individuals with new-onset type 2 diabetes. Those with continuous regular PA and, to a lesser extent, those who started to engage in regular PA had a lower risk of dementia. Regular PA should be encouraged to prevent dementia in high-risk populations and those with new-onset type 2 diabetes".

For further information:

DOI: https://doi.org/10.2337/dc21-1597

Keywords: New-onset type 2 diabetes, physical activity, lack of physical activity,dementia, alzheimer disease, vascular dementia, regular exercise, Diabetes Care.